How to Manage and Prevent a Panic Attack

Palms are sweaty. Knees weak. Arms are heavy. These aren’t just the lyrics to an Eminem song, they are also tell-tale signs of a panic attack. These symptoms usually come from out of nowhere and can be really scary to the person experiencing them. Maybe you’ve experienced something similar, or know somebody who has. We talk about grown-ups experiencing panic attacks, but did you know that children have them, too?

Psychotherapist and founder of Northside Mental Health, Kate Fisch, LCSW, helps parents of special needs children better understand how to spot a panic attack and ways to de-escalate a panic attack once it begins.

Spotting a panic attack

Panic attacks seemingly come out of nowhere, making it difficult for parents to intervene before their child is in the midst of the attack. Once a child is panicking, there are lots of indicators, including:

  • A change in mood
  • Physical symptoms, such as rapid heart rate, shaking, sweaty palms, difficulty breathing, crying
  • Expressing a sense of feeling out of control, or afraid of something they cannot specifically identify

Is it a panic attack or a tantrum?

The differences between a panic attack and a tantrum include frequency, duration and intensity.

Panic Attack:

  • Sometimes only occur a few times a year, but with a panic disorder, they might experience attacks 10-20 times a month
  • Can last up to 30 minutes but typically peak after 10 minutes, and will most likely be more intense than a tantrum
  • Do not have an obvious trigger


  • A child can typically communicate what they are upset about
  • The source might be more obvious, like denying a child’s request, setting a limit, or enforcing a rule
  • Typically do not last as long as a panic attack

De-escalating panic attacks

It’s important to remain as calm as possible in order to represent a place of safety and security. Use soothing words like, “I know this is big and scary, but you are safe with me and we will get through this together.”

Part of why panic attacks are so terrifying is there is a sense of “unreality” and children’s brains are not developed enough to understand what is happening, or communicate how they are feeling. Parents can help a child with a “name it to tame it” strategy, such as, “You are feeling afraid right now.” Also, it’s helpful to remove the child from anything that might be overstimulating. For example, if an attack happens at a noisy restaurant, walk the child outside or somewhere quiet and calm.

It’s important to understand the child’s body is reacting to some (falsely) perceived threat. Help calm your child’s brain by encouraging deep breaths. Intentionally increasing the body’s oxygen level helps the brain understand the threat has passed. Consider wrapping your own body around your child’s to encourage them to match your breathing.

Preventing panic attacks

Panic attacks are a product of underlying anxiety, which is something parents can help reduce on a regular basis. Regularly including mindfulness activities and techniques is a good idea. Mindfulness is the idea that we are intentionally paying attention to the present moment instead of the future or the past. Parents can also help their child feel less helpless during a panic attack by incorporating resiliency based language in everyday moments, such as “I know you can handle this.”

Panic attacks are scary for the children experiencing them and for the parents trying to help manage them. If the frequency of panic attacks increases, be sure to contact your child’s physician so that a treatment plan can be developed. It is also recommended that you notify any other adult that may be in close contact with your child, such as teachers, guidance counselors or daycare providers so that they know how you would like an attack to be handled should it occur while your child is in their care.

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